Intensidad de Cuidados Durante las Estancias Hospitalarias Inapropiadas: Project Research in Nursing y Appropriateness Evaluation Protocol

ReseumenObjetivoDeterminar la proporción de las estancias inapropiadas y la tipología e intensidad de cuidados de enfermería en las mismas, en determinados grupos de diagnósticos relacionados (GDR).MétodosEn una cohorte de pacientes ingresados entre los meses de febrero a julio del año 1997, se estudió la intensidad de cuidados de enfermería y la adecuación del penúltimo día de estancia. La población de estudio fueron 494 pacientes ingresados en el Consorci de l'Hospital de la Creu Roja de l'Hospitalet de Llobregat, que al alta se clasificaron en uno de los 10 GDR más frecuentes. La información utilizada se obtuvo a partir de la historia clínica y de las hojas de registro del sistema PRN. Se evaluaron variables datos sociodemográficos del paciente, actividades de cuidados de enfermería y la adecuación del uso de la hospitalización con el AEP, el día anterior al alta. Para la comparación de las estancias inapropiadas con las apropiadas, se realizó un análisis de ji cuadrado para la comparación de variables categóricas y la t de Student para las continuas. Mediante un modelo de regresión logística se estudiaron los factores asociados de forma independiente con la inadecuación de la estancia.ResultadosDe los 417 procesos válidos, en 269 (64,5%) se consideró la estancia apropiada y en 148 (35,5%) inapropiada. La edad media de las estancias inapropiadas fue significativamente superior a las estancias apropiadas (70,06 ± 13,84 vs 61,57 ± 15,07, p < 0,05). La intensidad de cuidados para las estancias inapropiadas fue mayor que en las apropiadas (mediana 137 (valor mínimo 45, valor máximo 355) vs mediana 95 (valor mínimo 35, valor máximo 1310) p < 0,001). Las estancias inapropiadas presentaron un tiempo de cuidar significativamente mayor que las estancias apropiadas, en las actividades de movilización, eliminación e higiene. En un modelo de regresión logística, la edad, la intensidad de cuidados en la alimentación, en los tratamientos y el GDR asignado a cada proceso, fueron factores predictivos independientes de estancia inapropiada. La aplicación del AEP se pudo hacer en el 56,9% de los procesos con las hojas de registro del PRN y el 43,1% se revisaron mediante la historia clínica.ConclusionesEn los GDR estudiados, los pacientes que presentan estancias inapropiadas, consumen una mayor intensidad de cuidados básicos de enfermería, por lo que serían candidatos de recibir una asistencia a domicilio y/o sociosanitaria. Las hojas de registro del PRN permiten disminuir el tiempo de revisión al aplicar el AEP.AbstractsObjectiveTo determine the proportion of inappropriate hospital stays, their typology and the level of nursing care in Diagnosis Related Groups(DRG). To evaluate the use of the PRN (Project Research in Nursing)register forms, when determining AEP (Appropriateness Evaluation Protocol).MethodA cross-sectional study was performed on 494 patients classified with one of the 10 more frequent DRG in the hospital from February to July 1997. Information from patient clinical histories, PRN register forms, sociodemographic data, and nursing care activities were used. The appropriateness of hospital stay to AEP was assessed on the day prior to discharge. Comparison of inappropriate stays with appropriate stays was performed by chi-square test for categorical variables and Student t-test for continuous variables. The independent associated factors with inappropriateness of hospital stay, were estimated using a log regression model.ResultsOut of 417 valid cases, hospital stay was considered appropriate in 269 (64.5%) patients and inappropriate in 148 (35.5%) patients. Mean-age of inappropriate stays was significantly higher than that of appropriate stays (70.06±13.84 vs 61.57 ± 15.07, p < 0.05). Care intensity for inappropriate stays was larger than that of appropriate stays (median 137 [minimal value 45, maximal value 355] vs median 95 [minimal value 35, maximal value 131] p < 0.001). Care time in mobilization, elimination and hygiene activities was longer in inappropriate stays than in appropriate stays. In a log regression model, the age, feeding care intensity, therapy care intensity and DRG assigned to each process were independent predictive factors of inappropriate stays. For application of AEP, 56.9% of cases were reviewed using PRN register forms and 43.1% were reviewed using the case history.ConclusionsFrom the DRG examined, patients who undertook inappropriate stays consumed a large intensity of nursing basic activities; therefore, they may be candidates for receiving home care and/or sociosanitary care. PRN register forms afforded a decreased review time on applying the AEP

Factors Affecting the Association of Single- and Double-Stranded RNAs with Montmorillonite Nanoclays

Montmorillonite (MMT) nanoclays exist as single and stacked sheet-like structures with large surface areas that can form stable associations with many naturally occurring biomolecules, including nucleic acids. They have been utilized successfully as vehicles for delivery of both drugs and genes into cells. Most previous studies have focused on interactions of MMT with DNA. In the current study, we have investigated the binding of small RNAs similar to those used for RNA interference (RNAi) therapy to two major forms of the clay, Na-MMT and Ca-MMT. Association of both forms of MMT with several double-stranded RNAs (dsRNAs), including 25mers, 54mers and cloverleaf-shaped transfer RNAs, was weak and increased only slightly after addition of Mg2+ ions to the binding reactions. By contrast, ssRNA 25mers and 54mers bound poorly to Na-MMT but interacted strongly with Ca-MMT. The weak binding of ssRNAs to Na-MMT could be strongly enhanced by addition of Mg2+ ions. The strength of MMT-ssRNA interactions was also examined using inorganic anion competition and displacement assays, as well as electrophoretic mobility shift assays (EMSAs). The aggregate results point to a cation-bridging mechanism for binding of ssRNAs, but not dsRNAs, in the presence of divalent metal cations

TRACE ELEMENTS IN SHEEP AND GOATS REPRODUCTION: A REVIEW

The reproduction of small ruminants like goats and sheep managed under extensive range grazing conditions can be affected by nutrients availability and especially by the mineral content of the forages resources on the rangeland. It has been particularly demonstrated that trace elements can have equally, beneficial or detrimental effects, depending on its balance, on reproductive functions in small ruminants. Trace elements as copper, molybdenum, selenium and zinc play key role on the metabolism of carbohydrates, proteins and lipids; however, the mode of action by which these elements affect reproduction in sheep and goats are not completely understood, due to the complexity in the mode of action of the metallobiomolecules and the neuro-hormonal relationship. In this way, their absence or presence of these minerals in several organs, fluids, or tissues of the reproductive tract have allowed obtaining information on the metabolism and the role of these elements on reproduction in sheep and goats. On this regard, the objective of this document is to review the relationships and effects of some trace elements, on reproductive events in sheep and goats

EFFECT OF SEASON ON SERUM COPPER AND ZINC CONCENTRATIONS IN CROSSBRED GOATS HAVING DIFFERENT REPRODUCTIVE STATUS UNDER SEMIARID RANGELAND CONDITIONS IN SOUTHERN MEXICO STATE

The effect of season (rainy: RS, and dry: DS) and reproductive status on copper (Cu) and zinc (Zn) concentrations in blood serum of crossbred goats (BW= 36.01 ± 1.59 kg) were studied under semiarid rangeland conditions in Southern Mexico State. Blood samples from 80 crossbred goats were taken each season (RS and DS). The goats were clustered into 10 different groups considering their reproductive status. Concentrations of Cu and Zn in serum were assayed using atomic absorption. Data were analyzed using a general linear model procedure for a completely randomized design and differences among means were examined using a Tukey test. Blood serum concentrations of Cu and Zn were affected by reproductive status and season (P<0.001). In relation to the season, Cu and Zn serum levels were lower in RS than DS (P<0.05). Overall, kidded goats had the highest values (P<0.01) for Cu than other animals in both seasons (RS or DS). Anestrous goats had the lowest concentrations (P<0.01) for Zn during RS, while all goats at their second or more kidding, rearing single or twins, showed the highest concentrations of Zn (P<0.001) in this season. Adult goats in Southern Mexico State showed a deficiency of Cu and Zn, especially during RS. As such, mineral supplements should be provided with respect to these elements in feeding systems for goats under semiarid rangeland conditions in order to evaluate their impact on health and reproduction

Fungos micorrízicos arbusculares na recuperação de florestas ciliares e fixação de carbono no solo.

A associação micorrízica arbuscular estabelecida entre os fungos micorrízicos arbusculares (FMAs - Filo Glomeromycota) e as raízes das plantas tem papel fundamental na sobrevivência e nutrição das plantas. Nesta revisão, é salientado que a tríade floresta ciliar-fixação de carbono-fungos micorrízicos arbusculares deve ser considerada uma estratégia ambientalmente correta para recuperar áreas outrora ocupadas por florestas ciliares. São apresentadas brevemente as classes de solos que ocorrem em ambientes ripários e a entrada de carbono (C) nos ecossistemas terrestres. Posteriormente, é enfatizado que os fungos micorrízicos arbusculares possuem papel importante no processo de fixação de carbono no solo, visto seus efeitos na absorção de nutrientes pelas plantas e aumento na produção de biomassa vegetal em espécies arbóreas, principalmente espécies pioneiras e secundárias iniciais, utilizadas na recuperação de florestas ciliares. Outrossim, as hifas externas desses fungos impactam a estrutura do solo tanto fisicamente, pela ação física das hifas, como bioquimicamente, pela produção de uma glicoproteína. As estruturas diferenciadas pelos fungos, como esporos e hifas, também servem como via de entrada de C no solo, por meio de componentes celulares ricos em C. A recuperação de florestas ciliares pelo plantio de espécies arbóreas resulta na emergência de um novo serviço ambiental: a fixação de C, a qual pode ser incrementada quando no processo de recuperação seja considerada a inoculação com fungos micorrízicos arbusculares.Divisão 2 - Processos e propriedades do solo; Comissão 2.1 - Biologia do solo

Impact of Size, Secondary Structure, and Counterions on the Binding of Small Ribonucleic Acids to Layered Double Hydroxide Nanoparticles

Use of ribonucleic acid (RNA) interference to regulate protein expression has become an important research topic and gene therapy tool, and therefore, finding suitable vehicles for delivery of small RNAs into cells is of crucial importance. Layered double metal hydroxides such as hydrotalcite (HT) have shown great promise as nonviral vectors for transport of deoxyribose nucleic acid (DNA), proteins, and drugs into cells, but the adsorption of RNAs to these materials has been little explored. In this study, the binding of small RNAs with different lengths and levels of secondary structure to HT nanoparticles has been analyzed and compared to results obtained with small DNAs in concurrent experiments. Initial experiments established the spectrophotometric properties of HT in aqueous solutions and determined that HT particles could be readily sedimented with near 100% efficiencies. Use of RNA+HT cosedimentation experiments as well as electrophoretic mobility shift assays demonstrated strong adsorption of RNA 25mers to HT, with twofold greater binding of single-stranded RNAs relative to double-stranded molecules. Strong affinities were also observed with ssRNA and dsRNA 54mers and with more complex transfer RNA molecules. Competition binding and RNA displacement experiments indicated that RNA-HT associations were strong and were only modestly affected by the presence of high concentrations of inorganic anions

Modelado de la radiación solar global horaria sobre superficie inclinada mediante redes neuronales artificiales

Ponencia presentada en: XXIX Jornadas Científicas de la AME y el VII Encuentro Hispano Luso de Meteorología celebrado en Pamplona, del 24 al 26 de abril de 2006

Efectos de la pandemia por Covid-19 en el mercado laboral colombiano: identificando el impacto de restricciones sectoriales a la movilidad

En este trabajo evaluamos el efecto de la pandemia de Covid-19 y las restricciones de movilidad sectoriales implementadas para reducir la velocidad del contagio. Para identificar el efecto de estas políticas, explotamos la variación en el empleo y salarios en los sectores excluidos y no excluidos de las restricciones a la movilidad, así como el momento de su implementación. Las restricciones sectoriales a la movilidad tienen efectos negativos en el empleo, representando aproximadamente una cuarta parte de la pérdida total de empleo entre febrero y abril de 2020. Los patrones regionales de propagación de la enfermedad y otros componentes epidemiológicos y económicos, que afectaron al país durante este período, representan las tres cuartas partes restantes de la pérdida de empleos. Por lo tanto, debemos esperar importantes pérdidas de empleo incluso en ausencia de dichas restricciones. No encontramos un efecto significativo en el promedio de horas trabajadas o los salarios, lo que indica que la mayor parte del ajuste del mercado laboral tuvo lugar en el margen extensivo. Además, las restricciones a la movilidad sectoriales afectan principalmente a los trabajadores asalariados, mientras que el trabajo por cuenta propia responde principalmente a la propagación de la enfermedad.We assess the effect of the Covid-19 pandemic and the lockdown of some economic sectors on the Colombian labor market. We exploit the variation between excluded and non-excluded sectors from the lockdown, as well as the timing of the restriction policies, to identify the effect of sector-specific restriction policies. These restrictions had negative effects on employment, accounting for approximately a quarter of the total job loss between February and April of 2020; the remaining three quarters of the job losses can be attributed to the regional patterns of the disease spread, and other epidemiological and economic factors affecting the whole country during this period. Therefore, we should expect important employment losses even in the absence of such restrictions. In contrast, we find no significant effect of sector-specific restrictions on average worked hours or wages, indicating that most of the adjustment of the labor market took place in the extensive margin. Moreover, sector-specific restrictions only affect salaried workers, while self-employment is more responsive to the disease spread

On-line surface plasmon resonance biosensing of vascular endothelial growth factor signaling in intact-human hepatoma cell lines

Surface plasmon resonance (SPR) monitoring of biorecognition events at intracellular levels is a valuable tool for studying the angiogenic response of carcinoma living cells during tumor growth and proliferation. We report here a comparative study of two different strategies to detect human hepatoma cell interactions between transmembrane vascular endothelial growth factor receptor (VEGFR2) and vascular endothelial growth factor (VEGF). To monitor VEGFR2 activation after VEGF stimulation, intact hepatocellular carcinoma HepG2 or Huh7 cells (2 × 10 cells per mL) were directly immobilized on the sensor chip. Distinguishable SPR sensorgrams were obtained for each cell line depending on the time required for VEGFR2 activation. SPR signals for VEGF-VEGFR2 binding were inhibited by the VEGFR inhibitor, CBO-P11. The SPR response after VEGF stimulation/inhibition was in good agreement with the results observed by immunoblotting analysis. In a second approach we used intact cell lines as analytes. SPR analysis was done by injecting HepG2 and HuH7 cell suspensions (2-4 × 10 cells per mL) onto a sensor surface previously immobilized with VEGF via a thiol self-assembled monolayer (SAM). Specificity and reproducibility were evaluated reusing the same chip surface over more than 60 complete regeneration cycles. Comparison between both methods yielded differences in terms of reliability, making the latter strategy more effective for the analysis of real samples. The investigation of VEGF signaling in intact human hepatoma living cells by SPR monitoring comprises a novel and promising design for the study of tumor angiogenesis via downregulation of VEGF and VEGFR2 pathways. Further investigation on VEGFR activation and vascular function could contribute to establish a robust and meaningful tool for early cancer diagnostics